MassHealth to reinstate coverage to 739 members

MassHealth staff told us Friday that they would be reinstating coverage to 739 members who had recently received termination notices due to missing paperwork. This is terrific news and reflects the strong commitment by the Governor, EOHHS and MassHealth to maximizing coverage.

Background: Back last July, a new federal law took effect (part of the DRA – Deficit Reduction Act) that asked U.S. citizens to submit proof of their citizenship status and identity in order to receive Medicaid benefits. The law, while ostensibly dealing with immigration, puts the burden solely on U.S. citizens, who must submit either a passport or a birth certificate and driver’s license, or other documents when applying or when their annual renewal comes up. The proposal was not requested by the Bush administration, but came from the Republican House.

A just-released national study found that Medicaid enrollment was declining in a number of states due to the requirement, particularly among low-income children.

Massachusetts: Massachusetts began implementing the law last fall. In an attempt to reduce barriers to enrollment, MassHealth now matches applicants and redeterminations against federal Medicare databases. They will soon be able to match with the driver license database, and with DPH birth records since 1988 (births before then are not computerized). Also starting soon is a new form that will allow DPH to directly send pre-1988 birth certificates directly to MassHealth. The Mass birth certificates are free under a budget provision we championed last year.

MassHealth also decided to allow current members more time to comply with the requirement. As a result, some 794 members who received closing notices (they went out Jan. 9-19) will be reinstated, probably by the end of this week. If anyone who received a notice needs immediate medical attention, please call our helpline and we will arrange for emergency reinstatement.

Next Steps: MassHealth officials have been responsive to a number of suggestions made by us, legal advocates like Mass Law Reform Institute, insurers and providers. In the coming days we hope MassHealth will take further steps to protect coverage for low-income people dependent on health benefits:

  1. Assist applicants and members with out-of-state birth certificates. A number of states have set up dedicated units to obtain these documents, and Massachusetts should follow their lead.
  2. Provide interim benefits to applicants while documents are being obtained. Several states are doing this as well. Currently, applicants are ineligible for any program until their paperwork is submitted. The exclusion extends to Commonwealth Care and the Uncompensated Care Pool. Someone applying with urgent medical needs has no coverage for their care. Providing interim benefits allows for prompt attention to medical problems, preventing small problems from becoming more serious due to lack of treatment.

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